Q&A Topic: Cervical Stenosis

October 5, 2016

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Marshal D. Peris, MD, FAAOS

Q. What is cervical stenosis?

A. Cervical stenosis (stenosis means “narrowing”) occurs when there isn’t enough room in the neck’s spinal canal for the spinal cord. When the canal’s diameter decreases, blood flow to the spinal cord supplying oxygen and nutrients is diminished, “starving” the cells inside the cord; nerves branching from the spinal cord can also be damaged. Usually the condition develops from normal wear and tear of the spine, which produces herniated or degenerative discs, arthritis, or bone spurs that infringe upon the space required by the spinal cord.

Q. What are the symptoms of cervical stenosis?

A. The most common complaint is arm pain that can be debilitating, as well as weakness and/or numbness in the hands and arms. Typically, the first symptom is intermittent numbness in one or both hands that becomes persistent. In severe cases, there can be substantial neurological impairment: balance is poor and people often need a walker; hand function can be so damaged, people can’t feed themselves.

Q. What are my treatment options?

A. A person diagnosed with cervical stenosis should consider surgery, as the condition will only get worse. Surgery is not curative, though many patients’ symptoms improve. Rather, surgery prevents further loss of space in the spinal canal and further deterioration of function. If the cause is disc-related, a disc and/or bone spur or part of the vertebra is removed, and replaced with an implant. Northern Westchester Hospital (NWH) orthopedic surgeons are at the forefront in using the very latest FDA-approved implant technology. If the cause is congenital, arthritic or involves the entire cervical spine, bone is removed from the back of the spine to widen the canal. Vertebrae are usually locked together using the fusion procedure so the head remains properly supported.

Q. Whom should I see if I have symptoms?

A. See a primary physician, neurologist, physiatrist, orthopedist, or neurosurgeon, all of whom will conduct a physical exam and order tests. A neurologist may do a nerve test (EMG), and you may have MRI or CAT scan imaging. The MRI is preferable, as it shows the spinal cord, discs, and area of inflammation.